Chaulin Aleksey Michailovich
Department of Cardiology and Cardiovascular Surgery, Samara State Medical University, Samara, 443099, Russia.
Department of Histology and Embryology, Samara State Medical University, Samara, 443099, Russia.
Cardiovasc Hematol Agents Med Chem. 2023;22(1):7-16. doi: 10.2174/1871525721666230314101019.
Statin drugs have long been used as a key component of lipid-lowering therapy, which is necessary for the prevention and treatment of atherosclerosis and cardiovascular diseases. Many studies focus on finding and refining new effects of statin drugs. In addition to the main lipidlowering effect (blocking cholesterol synthesis), statin drugs have a number of pleiotropic effects, including negative effects. The main beneficial effects of statin drugs on the components of the cardiovascular system are: anti-ischemic, antithrombotic, anti-apoptotic, antioxidant, endothelioprotective, anti-inflammatory properties, and a number of other beneficial effects. Due to these effects, statin drugs are considered one of the main therapeutic agents for the management of patients with cardiovascular pathologies. To date, many review manuscripts have been published on the myotoxicity, hepatotoxicity, nephrotoxicity, neurotoxicity and diabetogenic effects of statins. However, there are no review manuscripts considering the negative effect of statin drugs on myocardial contractile cells (cardiomyocytes). The purpose of this review is to discuss the negative effects of statin drugs on cardiomyocytes. Special attention is paid to the cardiotoxic action of statin drugs on cardiomyocytes and the mechanisms of increased serum levels of cardiac troponins. In the process of preparing this review, a detailed analysis of laboratory and experimental data devoted to the study of the negative effects of statin drugs on cardiomyocytes was carried out. The literature search was carried out with the keywords: statin drugs, negative effects, mechanisms, cardiac troponins, oxidative stress, apoptosis. Thus, statin drugs can have a number of negative effects on cardiomyocytes, in particular, increased oxidative stress, endoplasmic reticulum stress, damage to mitochondria and intercalated discs, and inhibition of glucose transport into cardiomyocytes. Additional studies are needed to confirm and clarify the mechanisms and clinical consequences of the negative effects of statin drugs on cardiomyocytes.
他汀类药物长期以来一直被用作降脂治疗的关键组成部分，这对于动脉粥样硬化和心血管疾病的预防和治疗至关重要。许多研究致力于寻找和细化他汀类药物的新作用。除了主要的降脂作用（阻断胆固醇合成）外，他汀类药物还有许多多效性作用，包括负面影响。他汀类药物对心血管系统各组成部分的主要有益作用包括：抗缺血、抗血栓形成、抗凋亡、抗氧化、内皮保护、抗炎特性以及许多其他有益作用。由于这些作用，他汀类药物被认为是治疗心血管疾病患者的主要治疗药物之一。迄今为止，已经发表了许多关于他汀类药物的肌毒性、肝毒性、肾毒性、神经毒性和致糖尿病作用的综述手稿。然而，尚无考虑他汀类药物对心肌收缩细胞（心肌细胞）负面影响的综述手稿。本综述的目的是讨论他汀类药物对心肌细胞的负面影响。特别关注他汀类药物对心肌细胞的心脏毒性作用以及心肌肌钙蛋白血清水平升高的机制。在撰写本综述的过程中，对致力于研究他汀类药物对心肌细胞负面影响的实验室和实验数据进行了详细分析。文献检索使用的关键词为：他汀类药物、负面影响、机制、心肌肌钙蛋白、氧化应激、细胞凋亡。因此，他汀类药物可能对心肌细胞产生多种负面影响，特别是增加氧化应激、内质网应激、线粒体和闰盘损伤以及抑制葡萄糖转运进入心肌细胞。需要进一步的研究来证实和阐明他汀类药物对心肌细胞负面影响的机制和临床后果。
